Claire Levy: What should be in the health-care bill

Congress is having difficulty writing a health-care act. The House was only able to pass a bill because its members knew its "American Health Care Act" wouldn't become law.

It's easy to chant "repeal." Turns out it's a lot harder to replace if your goal is providing health care.

What should a health-care bill aspire to do?

Here are some ideas. People who cannot afford to buy health insurance still need health care. After all, we should assure that no one suffers or dies for lack of treatment just because they are poor. The Medicaid expansion covered childless adults with income under 138 percent of the federal poverty level. Health insurance is simply unaffordable at that income; this population was previously uninsured and using emergency rooms for care. So, a health-care bill must preserve the Medicaid expansion and provide enough funding so states can afford it.

There should be help for people who earn more but still can't afford health insurance. They should buy their own insurance, but they should have help paying premiums, co-pays and deductibles. Health insurance is already too costly for this group. That means keeping, not reducing, existing premium tax credits and cost-sharing assistance.

Most agree people with preexisting conditions need health insurance. But health insurance companies can't afford to cover them unless they also cover a lot of healthy people. Health insurance only works if it's universal. So, if we are going to rely on private insurance companies as the principal source of insurance, then everyone must participate. Any bill must keep the individual mandate.

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What's missing? Tax cuts for wealthy people. If they helped provide health care they should be included. But they don't.

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